http://www.diabetesincontrol.com/issue118/item4.shtml
Radical Treatment for Diabetics Gets Green Light
Treatment uses intravenous transplants of insulin-producing pancreatic
cells extracted from dead donors
A radical treatment for diabetes invented overseas that uses intravenous
transplants of insulin-producing pancreatic cells extracted from dead donors
is to be made available for the first time in Japan, maybe by the end of the
month.
A group of doctors, headed by Takashi Kenmochi of Sakura Hospital in Chiba
Prefecture, has been studying the technique since 1996 and recently finished
compiling a manual on the treatment.
Initially, the procedure will only be available for insulin-dependent
diabetics, whose pancreas cannot secrete insulin--a hormone that controls
the level of blood sugar--and have to inject themselves with insulin to
compensate for the defect.
Insulin-dependent diabetics account for 4 percent to 6 percent of the
nation's diabetics, estimated to total more than 6 million.
Pancreatic cells, also known as islets of Langerhans, are spherical cell
clusters 0.1 millimeter to 0.3 millimeters in diameter. The pancreas of an
average healthy adult contains about 1 million pancreatic cells.
The group is ready to start laying the groundwork for pancreatic transplants
as soon as a donor pancreas becomes available. After the pancreas is
harvested, the pancreatic cells will be extracted by a centrifugal separator
and frozen, the group said.
When the team has built up a supply of the cells, it will begin treatment of
the most serious diabetic cases. The cells will be injected into the portal
vein, which carries blood from the digestive system and spleen to the liver.
The cells, once they take root in the liver, will start secreting insulin.
One of the biggest advantages of the treatment is that, unlike transplanting
an entire pancreas, the procedure does not require an operation, reducing
the physical stress on a patient.
In addition, doctors need only obtain the consent of the donor's family to
harvest the pancreas.
The manual prepared by the group lists the following criteria that must be
met before the treatment can be offered:
-- The attending physician shall provide patients seeking the treatment and
their families with adequate explanations about the procedure.
-- The separation and storage of pancreatic cells must be conducted at
medical institutions that meet standards defined in the manual to ensure
uniformity in treatment.
-- Medical personnel involved in the treatment shall take the utmost
precautions to protect the privacy of donors and recipients.
The treatment has been in use overseas since the early 1990s on more than
500 patients, a large proportion of whom were completely cured.
While the transplant of an entire pancreatic remains the most effective
treatment, there is a short supply of donor organs and a large waiting list.
The group said that pancreatic cells will be extracted only from pancreases
that are not suitable for transplants, so that the treatment will complement
pancreatic transplants and not deplete an already sparse resource.
While acknowledging that only a few insulin-dependent diabetics will benefit
from the treatment in the early years, the group said the treatment may
become applicable to a regenerative medicine-based treatment in which
insulin-producing cells are created from stem cells, which possess the
ability to metamorphize themselves into differentiate types of cells
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DID YOU KNOW
If you have diabetes, you have the same high risk of having a heart attack
as someone who has already had their first attack, said Dr. Charles Clark,
National Diabetes Education Program Chair. Even worse, your chances of
dying from your first heart attack are the same as someone without diabetes
who has had a second heart attack.
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